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What do chronic obstructive pulmonary disease patients die from? A multiple cause coding analysis.
A L Hansell1, J A Walk, J B Soriano
1Dept Epidemiology and Public Health, Imperial College London, London, UK. a.hansell@imperial.ac.uk
The European Respiratory Journal
|November 19, 2003
Summary
Obstructive lung disease (OLD) deaths are underestimated when only considering the underlying cause. Analyzing all mentioned conditions reveals a greater mortality burden for OLD in England and Wales.
Area of Science:
- Public Health
- Epidemiology
- Respiratory Medicine
Background:
- Mortality data for obstructive lung disease (OLD), including chronic obstructive pulmonary disease (COPD) and asthma, typically relies on the underlying cause of death listed on certificates.
- This approach may underestimate the true impact of OLD by overlooking other contributing conditions mentioned.
Purpose of the Study:
- To assess the full contribution of obstructive lung disease to mortality by analyzing all conditions listed on death certificates.
- To compare the ascertainment of OLD deaths versus myocardial infarction deaths using underlying cause versus all mentioned causes.
Main Methods:
- Descriptive analysis of all conditions recorded on death certificates in England and Wales between 1993 and 1999.
- Inclusion criteria: decedents where OLD (COPD or asthma) was mentioned as a contributing cause of death.
Main Results:
- Obstructive lung disease was mentioned in 312,664 deaths (8.0% of all deaths).
- OLD was the underlying cause in only 59.8% of deaths where it was mentioned.
- When OLD was not the underlying cause, leading causes included circulatory diseases, neoplasms, and other respiratory diseases.
Conclusions:
- Relying solely on the underlying cause of death underestimates the mortality burden of obstructive lung disease in England and Wales.
- In contrast, the underlying cause of death accurately captures most mentions for myocardial infarction (94%).